Provider Demographics
NPI:1851650584
Name:MASHAYEKHI, PEGAH MARYAM (DO)
Entity Type:Individual
Prefix:MS
First Name:PEGAH
Middle Name:MARYAM
Last Name:MASHAYEKHI
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:15611 POMERADO RD FL 3
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-2437
Mailing Address - Country:US
Mailing Address - Phone:858-618-1191
Mailing Address - Fax:858-207-5042
Practice Address - Street 1:15611 POMERADO RD FL 3
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2437
Practice Address - Country:US
Practice Address - Phone:858-618-1191
Practice Address - Fax:858-207-5042
Is Sole Proprietor?:No
Enumeration Date:2012-05-15
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A12987207R00000X, 207RS0012X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A12987OtherMEDICAL LICENSE